Students in a Clinical Setting
Evaluating student performance of any kind is always a controversial issue. However, assessing nursing skills is a particularly serious and controversial subject, given that if assessment is inadequate, the consequences for patients can be dire. It is essential that the evaluation of new nurses be accurate, particularly given the hope that many new nurses will be entering the profession, the result of new initiatives designed to cope with the pending nursing shortage due to the retirement of the current generation of older nurses. A review of existing literature indicates that the evaluation of nurses' competency is deemed to be problematic world-wide. Various strategies to remedy this have been suggested, including more rigorous training of and support for mentors who grade student nurses as well as the use of more objective assessment instruments.
According to Gopee (2008) in her article "Assessing student nurses' clinical skills: the ethical…...
mlaReferences
Gopee, N. (2008). Assessing student nurses' clinical skills: the ethical competence of mentors. International Journal of Therapy & Rehabilitation, 15(9), 401-407.
Karayurt, O., Mert, H., & Beser, A. (2009). A study on development of a scale to assess nursing students' performance in clinical settings. Journal of Clinical Nursing, 18(8), 1123-1130. doi:10.1111/j.1365-2702.2008.02417.x
Oermann, M. (2009 et al.). Clinical evaluation and grading practices. Schools of Nursing:
National Survey Findings Part II. Nursing Education Perspectives, 30(6), 352-357.
learners a clinical setting --Desirable staff role models? What risks mitigated?
Discuss three assessment strategies you would use to evaluate the effectiveness of a clinical instructor
In-class, scheduled observations are one of the most common methods used to assess the effectiveness of instructors. Of course, this method is not foolproof -- an instructor will likely show off the class at its best, when he or she is anticipating a visit from an evaluator. However, even a planned visit at least demonstrates to the evaluator what the teacher believes are his or her strengths. The teacher's method of interacting with the class, the classes' responsiveness to the teacher's demeanor and the teacher's method of structuring the lesson plan can all be reviewed.
Unplanned observations, of course, take away the ability of the teacher to prepare for a visitor (although the teacher can be warned that unplanned assessments will occur throughout the semester). These…...
mlaReferences
Cardillo, Donna. (2005). Do nurses eat their young? Nurse Week. Retrieved:
http://www.nurseweek.com/news/Features/05-01/DearDonna_01-10-05.asp
Murray, Cyril & Andrew Main. (2005). Role modeling as a teaching method for student mentors. Nursing Times, 101 (26: 30). http://www.nursingtimes.net/nursing-practice-clinical-research/role-modelling-as-a-teaching-method-for-student-mentors/203794.article
Patient Acuity ScalesLiterature ReviewAccording to DiClemente (2018), nurses have a moral as well as professional obligation to ensure that patient have access to the best possible level of care. This could be achieved via the deployment of a wide range of ideals, systems and tools. Patient acuity could be conceptualized as one of the most instrumental patient classification systems (Garcia, 2017). In the words of the author, acuity comes in handy in efforts to project how many nursing care hours are needed to optimize patients ability to improve (Garcia, 2017, p. 477). Studies conducted in the past have clearly demonstrated that patient acuity scales have a positive impact on not only patient outcomes, but also patient satisfaction. Further, the said scales help increase staff satisfaction and decrease staff burnout.Patient acuity does not have an assigned definition. What this means is that in the past, various definitions have been offered by…...
mlaReferences
Connor, J.A., LaGrasta, C., Gauvreau, K., Porter, C., O’Brein, K & Hickey, P.A. (2019). Scaling the Measurement of Pediatric Acuity Using the Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO II) Tool. Dimensions of Critical Care Nursing, 38(3), 146-152.
Carlisle, B., Perera, A., Stutzman, S.E., Brown-Cleere, S., Parwaiz A. & Olson, D. (2020). Efficacy of Using Available Data to Examine Nurse Staffing Ratios and Quality of Care Metrics. Journal of Neuroscience Nursing, 52(2), 78 – 83.
DiClemente, K. (2018). Standardizing Patient Acuity: A Project on a Medical-Surgical/ Cancer Care Unit. MedSurg Nursing, 27(6), 355-387.
PRAC /6675 Clinical SkillsSelf-Assessment FormDesired Clinical Skills for Students to AchieveConfident (Can complete independently)Mostly confident (Can complete with supervision)Beginning (Have performed with supervision or needs supervision to feel confident)New (Have never performed or does not apply)Comprehensive psychiatric evaluation skills in:Recognizing clinical signs and symptoms of psychiatric illnessacross the lifespanxDifferentiating between pathophysiological and psychopathological conditionsxPerforming and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies)xPerforming and interpreting a mental status examinationxPerforming and interpreting a psychosocial assessment and family psychiatric historyPerforming and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).xDiagnostic reasoning skill in:Developing and prioritizing a differential diagnoses listxFormulating diagnoses according to DSM 5 based on assessment dataxDifferentiating between normal/abnormal age-related physiological and psychological symptoms/changesxPharmacotherapeutic skills in:Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management)xEvaluating patient response and…...
Decision Making in Clinical SettingsIntroductory Information about Interprofessional Engagement in Shared Decision-Making Definition of interprofessional engagement. Although no universal definition exists, interprofessional engagement can be regarded as the collaboration that occurs between professionals from different disciplines who work together to identify and solve problems as well as formulating treatment strategies. The engagement process is based on a teamwork approach that draws on the knowledge and experience of various fields to develop comprehensive solutions to frequently complex problems (Fang, 2023). History of interprofessional engagement. It is reasonable to suggest that humankind has relied on interprofessional engagement in some form since time immemorial when different people were recognized as possessing prized skills that were not shared by many others. In a modern context, however, the history of interprofessional engagement can be traced to the late 1960s when teamwork became the cornerstone for effective collaboration as primary care centers (Barr, 2019). Impact of…...
mlaReferencesBarr, H. (2019, April 1). Medicine and the making of interprofessional education. British Journal of General Practice, 60(573), 296-299.Clarke, A. J., Burgess, A., van Diggele, C., Bloomfield, J., Schneider, C., Kalman, E., & Walton, M. (2023). Improving Patient Safety: Engaging Students in Interprofessional Team-Based Learning (TBL). Journal of University Teaching and Learning Practice, 20(5).Elwyn, G. et al. (2006, August 14). Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. British Medical Journal, 2-6.Fang, B. (2023). Bridging the Gap Between Research and Practice of Engagement: Toward a Collaborative Human Resource Development. Advances in Developing Human Resources, 25(2), 95–115.The Importance of Interprofessional Collaboration in Healthcare. (2023, September 10). Johnson & Johnson: Nursing. Retrieved from F. et al. (2011, January). Interprofessionalism and shared decision-making in primary care: a stepwise approach towards a new model. Journal of Interprofessional Care, 25(1), 18-25.Marks, L., O’Sullivan, L., Pytel, K., & Parkosewich, J. A. (2022). Using a teach-back intervention significantly improves knowledge, perceptions, and satisfaction of patients with Nurses’ discharge medication education. Worldviews on Evidence-Based Nursing, 19(6), 458–466.Our Mission and Vision. (2024). Joint Commission. Retrieved from https://www.joint commission.org/who-we-are.https://nursing.jnj.com/getting-real-nursing-today/the-importance-of-interprofessional-collaboration-in-healthcare.LeGare,
According to the AACN's report, "Nurse Practitioner Primary Care Competencies in Specialty Areas: Adult, Family, Gerontological, Pediatric, and Women's Health" (2002), "Competencies are the domain or body of knowledge and skills that essentially define a profession or discipline. This domain of competencies guides training programs, provides expectations for employers, and drives the nature of assessment instruments and performance standards for credentialing institutions, certifying agencies, and accrediting organizations" (p. 14).
The core competencies for nurse practitioner graduates are intended to help candidates used what they have already learned and require a graduate-level education in order to attain certification as an APN and the AACN has developed this graduate curriculum as the basis for advanced practice nursing. As described by AACN, advanced practice nursing preparation includes ". . . graduate nursing core content (e.g., research, health policy, ethics, and more) and advanced nursing practice content (e.g., advanced health assessment, advanced physiology and…...
Since modern medicine can sustain patients with proper medical follow-up for years, it becomes incumbent on the profession to follow the patients and provide them with the knowledge and tracking to insure that they are observing the procedures and medications which prolong their quality of life. Given hospitals' short-term orientation with the patients, there is a need to bridge patient care before, during and after acute-care visits.
While there are some nursing specialties which can be regarded as solely hospital- or community-based, many of the specialties call for a more holistic notion of patient care. y combining the CNS and NP specialties, this profession has a better chance of assuring better patient outcomes, and a better quality of life for the patient.
ibliography
ennett, .J. (1998). Psychiatric mental health nursing: thriving in a changing environment through outcomes-based measurements. Semin. Nurse Manage., 144-148.
erger, a.M.-F. (1996). Advanced practice roles for nurses in tomorrow's healthcare systems.…...
mlaBibliography
Bennett, B.J. (1998). Psychiatric mental health nursing: thriving in a changing environment through outcomes-based measurements. Semin. Nurse Manage., 144-148.
Berger, a.M.-F. (1996). Advanced practice roles for nurses in tomorrow's healthcare systems. Clinical Nurse Specialist, 250-255.
Chaska, N.L. (2001). The Nursing Profession Tomorrow and Beyond. Thousand Oaks: Sage.
Cukr, P.L. (1997). The psychiatric clinical nurse specialist/nurse practitioner: an example of a combined role. Arch Psychiatr Nurs, 2-12.
Salary
Employment Opportunities
Clinical coding specialists may work in hospitals, clinics, ambulatory, long-term and mental health care facilities, physicians' offices and government agencies that need coding expertise. (Western Kentucky University Website "Clinical Coding Specialist," 2003, NP)
Professional Association
American Health Information Management Association
233 N. Michigan Ave. Suite 2150
Western Kentucky University Website "Clinical Coding Specialist," 2003, NP)
According to an interview I conducted with a CCS, the traditional route to becoming a CCS has been to learn the systems on the job, especially with regard to institution specific computer coding systems, with minimal additional facility sponsored continuing education credit hours per year, yet as the job becomes increasingly important, with regard to accountancy and cost containment in medical care more and more institutions are requiring certification and therefore prior education with regard to clinical coding. The professional noted that when she began her job 15 years prior it was not unusual to hire people with minimal…...
mlaReferences
Johns, M.L. (2007) Information Management for Health Professionals Second Edition. AHIMA.
Tinsley, R. (1993). Engagements for Medical Professionals. Journal of Accountancy, 175(4), 34.
Western Kentucky University Website (2003) "Clinical Coding Specialist" Accessed September 8, 2008 http://www.wku.edu/Dept/Academic/chhs/scahec/clinicalcoding.htm
In clinical situations, for example, problem-solving techniques are often required to ensure best practice. According to Lyth, some authors argue that a balance between roles should be maintained in order to optimize both clinical practice and theoretical knowledge.
Generally, it appears to be agreed among theorists that the focus of clinical supervision should be professional development and self-actualization. In addition, an inter-disciplinary approach to supervisory practice will also provide a platform for emerging best practice among the various professions, and ultimately benefit the practice in nursing. Although it appears that the theory on clinical supervision is often arbitrary and little researched, it is also true that the phenomenon has been in effect of many years, decades, and even centuries. For midwives, for example, supervision has been part of their profession since 1902, being a statutory requirement.
One problem with clinical supervision, according to Lyth (2000, p. 276), is the fact that…...
mlaReferences
Lyth, Gordon M. (2000). Clinical supervision: a concept analysis. Jounral of Advanced Nursing, Vol 31, No. 3.
Macdonald, Joanna. (2002, Feb). Clinical Supervision: a review of underlying concepts and developments. Australian and New Aealand Journal of Psychiatry, Vol. 35, Iss 1. Retrieved from http://www.informaworld.com/smpp/content~db=all~content=a772090191
McLean, Duncan (1996). Clinical Supervision. Psychiatric Bulletin, Vol. 20. Retrieved from http://pb.rcpsych.org/cgi/reprint/20/1/1.pdf
Todd, C. & O'Connor, J. (2005). Clinical Supervision. In N. Skinner, a.M. Roche, J. O'Connor, Y. Pollard, & C. Todd (Eds.), Workforce Development TIPS (Theory Into Practice Strategies): A Resource Kit for the Alcohol and Other Drugs Field. National Centre for Education and Training on Addiction (NCETA), Flinders University, Adelaide, Australia. Retrieved from http://www.unodc.org/ddt-training/treatment/VOLUME%20D/Topic%202/8.Workforce%20Development%20TIPS.pdf
Clinical Psychology
The field of clinical psychology emerged as a viable method through which the theoretical foundations of cognitive studies could be effectively applied within the clinical setting to prevent and treat psychological syndromes. Derived from the first clinical psychology work conducted by Lightner Witmer in the late 19th century, and expanding throughout the 20th century as diagnostic tools were refined and classification systems for mental disorders were standardized, modern clinical psychology has been adapted to fulfill a niche within a whole host of divergent fields, including criminal justice, the social sciences and gender relations. Clinical psychologists premise their work on the use of empirical analysis to accurately investigate matters of cognitive processing, psychological assessment and mental illness, with the administration of personality tests, neurological scans and clinical interviews the most frequently utilized diagnostic resources. As clinical psychology expanded the base of knowledge pertaining to the human brain's highly refined…...
mlaReferences
Blackburn, R. (1993). The psychology of criminal conduct: Theory, research and practice. John Wiley & Sons.
Donohue, J., & Levitt, S. (2001). The impact of race on policing and arrests. Journal of Law and Economics, 44, 367-394. Retrieved from http://pricetheory.uchicago.edu/levitt/Papers/LevittDonohueTheImpactOfRace2001.pdf
Fite, P.J., Wynn, P., & Pardini, D.A. (2009). Explaining discrepancies in arrest rates between
Black and White male juveniles. Journal of consulting and clinical psychology, 77(5), 916. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981137/ >.
Clinical Education
The objective of this study is to conduct a critical analysis of issues in clinical education. Toward this end, this study will conduct a review of literature in this area of inquiry.
The work of Strohschein, Hagler and May (2002) entitled 'Assessing the Need for Changes in Clinical Education Practice' reports a study that identifies areas of need within clinical education and well as describing "…various models and tools that are proposed and utilized in clinical education, as well as the exploration of the extent to which these models and tools might meet the identified needs of the clinical education process in physical therapy." (p.1) Physical therapists are reported as working in a health care climate "of increasing complexity and rapid change, of fiscal restraint and demands for accountability, of scrutiny from both internal and external sources. In such a climate, the ability to respond appropriately to these pressures…...
mlaBibliography
Cross V. (1997) The professional development diary: a case study of one cohort of physiotherapy students. Physiotherapy.1997; 83:375 -- 383.
Hagler P, McFarlane L. (1991) Achieving maximum student potential: the supervisor as coach. Canadian Journal of Rehabilitation.1991; 5:5 -- 16.
Hayes KW, Huber G, Rogers J, Sanders B. (1999) Behaviors that cause clinical instructors to question the clinical competence of physical therapist students. Phys Ther.1999; 79:653 -- 667.
Higgs J, Glendinning M, Dunsford F, Panter J. Goals and components of clinical education in the allied health professions. In: Proceedings of the 11th International Congress of the World Confederation for Physical Therapy, London.1991: 305 -- 307.
Clinical Education
There are many aspects to the nursing profession, but before a person becomes a nurse he or she has to focus on the clinical education it takes to become one. In other words, one cannot just study from books and pass tests to graduate to working with patients. He or she has to be able to demonstrate through clinical evaluation methods that he or she is capable of doing what is necessary to handle patients properly. Addressed here will be reasons behind the methods used. The humanistic and transformative learning theories will be discussed. Then the paper will move into the specific methods used for clinical evaluation, what those methods are, and why they are important. Overall, it is highly significant to have different kinds of methods, because everyone learns a little differently. When evaluations measure the same kinds of skills in different ways, they are more likely…...
mlaReferences
Bendeck S.S. ed. (2013). Psychology and the perennial philosophy: Studies in comparative peligion. Bloomington, IN: World Wisdom.
Billings & Halstead (2012). Teaching in nursing. A guide for faculty. (4th ed) NY: Saunders.
Cranton, P. (2006) Understanding and promoting transformative learning: A guide for educators of adults (2nd ed.). San Francisco, CA: John Wiley & Sons, Inc.
D'Antonio, P. (2010). American nursing: A history of knowledge, authority, and the meaning of work. NY: John Hopkins University Press.
Diagnosis and Assessment in a Clinical Setting
Given the information provided in the subjective portion of the note, the clinician would want to find out if the patient has ever engaged in anal intercourse. If the patient has engaged in such intercourse, the clinician would want to know how many partners she’s had in this regard and when was the last incidence of anal intercourse. The clinician would also want to find out if the patient used protection when engaging this form of intercourse. Getting the total number of partners that this woman has had over the past year might shed some light on the situation as well. Additionally, it might be worth asking if the patient has made an obvious changes in personal hygiene or underwear. For example, the sudden usage of baby wipes in the vaginal or anal area has been found to cause irritation in some cases. Likewise,…...
Empathy is the ability to understand and share the feeling of others in a genuine and often dynamic manner. It is the ability to put oneself in the shoes of others. It often indicates a genuine interest in the thoughts and feelings of others and their issues. These tends to create mutual beneficial relationships between multiple parties as each attempt to generate common ground.As it relates to clinical empathy, it is important for physicians to have both candid and genuine relationships with their respective patients. This is critical element to the overall relationship due in part to the overall sensitivity and complexity of health-related issues. My issues, particularly those that can result in severely adverse consequences require empathy from both parties. The more complex the circumstance, the more empathy is required so that the best healthcare decisions can be made. Elements such as addictions, break-ups, family abuse, and other more…...
Clinical supervision provides a mechanism of data collection and the information reclamation in support to the recent projects and the programmatic developments.
Management of the high number of complex mental health caseloads
These implementations occur under the influence of the Workplace Implementation Committees (WIC) that were established to the oversee agreement by the CMS at the local levels. The CMS is supposed to accompany the implementation of the policies that clearly outline the expectations and responsibilities based on periods and review methods (Cogan 1972). The implementations are expected to be transparent in the process of the WIC members and the staff groups. This includes the clear articulate mechanism for regular workload assessment, management and review.
I. egularly collect the workload from all the executives to make the caseload management process easier.
II. Use the caseload information to make the staff allocation of the resources while measuring their performances.
The workforce plan and individual plans…...
mlaReferences
Cogan, M.L. (1972). Clinical supervision. Boston: Houghton Mifflin.
ERIC Clearinghouse on Educational Management., & National Institute of Education (U.S.). (1984). Clinical supervision. Eugene, or: ERIC Clearinghouse on Educational Management, College of Education, University of Oregon.
Powell, D.J. (1980). Clinical supervision: [1]. New York: Human Science Pr.
Bernard, J.M., & Goodyear, R.K. (1998). Fundamentals of clinical supervision. Boston: Allyn and Bacon.
Paradigm Case Studies: A Valuable Tool for Nursing Education and Practice
Introduction
Paradigm case studies are narratives that present archetypal examples of nursing practice, encompassing the core values, principles, and behaviors of the profession. These case studies serve as valuable tools in nursing education and facilitate meaningful discussions that foster critical thinking, clinical judgment, and professional development.
Introduction and Facilitation of Concepts
Emulation of Best Practices: Paradigm case studies present examples of exemplary nursing care, showcasing strategies, interventions, and outcomes that adhere to evidence-based standards and best practices. This not only introduces new concepts but also reinforces existing knowledge.
Clarification of Complex Issues:....
1. The Impact of Mindfulness on Mental Well-being
Explore the concept of mindfulness and its benefits for mental health.
Examine research on mindfulness interventions and their effectiveness in reducing stress, anxiety, and depression.
Discuss the mechanisms through which mindfulness promotes psychological well-being, such as cognitive regulation and emotional awareness.
Consider the implications for promoting mindfulness in clinical settings, schools, and the general population.
2. The Role of Technology in Mental Health
Examine the potential benefits and risks of technology use on mental health.
Review empirical research on the impact of social media, digital entertainment, and online therapy on psychological well-being.
Discuss....
Thiamin, also known as vitamin B1, is an essential micronutrient that plays a crucial role in energy metabolism. It acts as a coenzyme in several key biochemical pathways, particularly in the decarboxylation of ?-keto acids and the pentose phosphate pathway. Thiamin is required for the conversion of carbohydrates into energy, making it vital for normal cellular function.
Thiamin deficiency, known as beriberi, can lead to a range of symptoms including muscle weakness, fatigue, and neurological disorders. Severe cases of thiamin deficiency can result in cardiovascular and neurological complications, making it a serious health concern. The prevalence of thiamin deficiency varies worldwide,....
Implementing Evidence-Based Practice in Nursing Care
Evidence-based practice (EBP) is a systematic approach to healthcare that incorporates the best available research, clinical expertise, and patient values to deliver optimal patient outcomes. In nursing care, implementing EBP has proven instrumental in enhancing the quality and effectiveness of interventions.
Benefits of EBP in Patient Outcomes
Improved Patient Safety:
EBP guidelines reduce medication errors, hospital-acquired infections, and other adverse events by providing standardized protocols based on proven research.
Risk assessment tools and early warning systems help identify and intervene on potential complications early on.
Enhanced Treatment Efficacy:
EBP supports the use of therapies and interventions that have....
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